OP-ED: Life-Saving Suicide Prevention Resources Address Critical Need in Juvenile Justice System

When it comes to high risk for suicide, youth in contact with the juvenile justice system stand out. It is alarming. Fortunately, staff within the system can play a crucial preventive role by working collectively to provide guidance, support and access to needed care. Studies show that up to 70 percent of youth in the system have a behavioral health problem, and for a large percentage, one or more life functions are significantly affected. An at-risk youth’s past nearly always includes multiple adverse childhood events; this, combined with the sense of hopelessness and isolation that ensues from the experience of confinement, increases the suicide risk for these youth to a level dramatically higher than for youth outside the system. The statistics are startling:

• Nearly one third of justice-involved youth report having experienced suicidal ideation in the past year and 36 percent have attempted suicide during their lifetimes (Nock et al., 2008).

• Suicide is the leading cause of death for youth in confinement (Bureau of Justice Statistics, 2005).

• Youth in residential facilities have nearly three times the suicide rate of peers in the general population (Gallagher & Dobrin, 2006).

• More than half of confined youth have current suicidal ideation (Esposito & Clum, 2001), and one-third have a history of suicidal behavior (Parent et al., 1994).

It is time to turn the tide. We must offer a brighter future to these youth. Everyone who contacts these youth, whether in juvenile justice, law enforcement, mental health, substance abuse, child welfare or education, must work collaboratively in order to successfully prevent suicide; and, in order for them to work collaboratively, the systems they work in must come together to provide “client-centered” services that are seamless to the individuals and families they serve.

Because of the intense level of daily interaction, some argue that suicide prevention in the juvenile justice system lies primarily in the domain of detention and other settings, whether secure or non-secure. However, preventing suicide must be a priority for providers at all points of contact within the system. Suicide prevention should begin at the initial point of entry and be coordinated to protect youth at the following points of contact:  referral/arrest, courts, probation, detention and aftercare.

To address this critical need, the National Action Alliance for Suicide Prevention (Action Alliance) has released a set of comprehensive suicide prevention resources to support staff working with youth in the juvenile justice system. The newly developed educational tools advance the National Strategy for Suicide Prevention (NSSP), which guides efforts to prevent suicide across the nation. Online versions of the nine resources are available to the juvenile justice workforce and the general public at: www.actionallianceforsuicideprevention.org/task-force/juvenilejustice

These materials were developed collaboratively over a three-year period by the Action Alliance’s Youth in Contact with the Juvenile Justice System Task Force, which included some of this country’s leading juvenile justice, mental health and suicide prevention experts. The work of the task force delivers the latest information on juvenile suicide prevention and provides practical strategies for interacting with these at-risk youth. These Action Alliance resources promote performance-based standards for juvenile correction and detention facilities and describe a comprehensive suicide prevention program encompassing all points of contact in the system. The covered components are:

• Training

• Identification; referral; evaluation

• Communication

• Housing (safe environment)

• Levels of observation; follow-up; treatment planning

• Intervention (emergency response)

• Reporting and notification

• Mortality-morbidity review

Another important resource for staff working with youth in the juvenile justice system is “Suicide Prevention in Juvenile Correctional Facilities,” a two-hour curriculum to help state juvenile correctional administrators and facility, training and mental health directors develop and implement comprehensive suicide prevention policies. This training can be accessed at (www.sprc.org/training-institute/juvenile-correctional-curriculum). This course was developed by the Suicide Prevention Resource Center (SPRC), in partnership with Council of Juvenile Correctional Administrators (CJCA), for use by administrators in states, territories, and major metropolitan counties. SPRC and CJCA also developed a two-part webinar series (housed on the same website as the course) titled “Suicide Prevention in Juvenile Detention and Correctional Facilities,” in partnership with the National Center on Institutions and Alternatives. Additionally, the staff training program, “Shield of Care: A System-Focused Approach to Protecting Juvenile Justice Youth from Suicide,” should be considered as a useful resource. Information on this program can be found on the federally funded Best Practices Registry (BPR) (www.sprc.org/bpr), which identifies, reviews and disseminates information about best practices that address specific objectives of the NSSP.

These youth deserve the care and attention of highly trained staff in every aspect of their contact with the system. With these resources now available, there is no reason we cannot raise the quality bar in every community across the nation and work to eliminate suicides among justice-involved youth. Yes, that goal will be difficult to achieve. If it was your child receiving services in the system, how many suicides would be acceptable to you?